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Altered brain dynamic functional connectivity in patients with obstructive sleep apnea and its association with cognitive performance.

Jing Wang,Zhijun Wang,Xin Wang,Lirong Ji,Ye-Zhou Li,Chaohong Cheng,T. Su,E. Wang,Fei Han,Rui Chen

Published 2025 in Sleep Medicine

ABSTRACT

OBJECTIVES Obstructive sleep apnea (OSA) is associated with potential disruptions in brain function and structure. The aim was to investigate alterations in dynamic functional connectivity (dFC) in OSA patients utilizing resting-state functional magnetic resonance imaging (rs-fMRI) and multiplication of temporal derivatives (MTD) to better understand the neurological implications of OSA. METHODS This cross-sectional study eventually recruited 111 patients, aged 25-65 years. We categorized participants based on the apnea-hypopnea index (AHI) assessed via polysomnography (PSG), 43 patients were groupAHI <15 and 68 patients were group AHI ≥15. Rs-fMRI and neuropsychological assessments were conducted to assess the brain function and visual-spatial memory, respectively. We evaluated the intergroup differences in dFC as well as its correlation with clinical parameters. RESULTS The dFC analysis identified five distinct connectivity states, comprising four hyperconnected states (State 1, 2, 3, and 5) and one hypoconnected state (State 4). Group AHI≥ 15 showed altered fraction time (FT) and mean dwell time (MDT) in States 1, 3, and 4. The partial correlation showed that the FT/MDT of State 1 negatively correlated with hypoxia parameters, while the FT/MDT of State 3 positively correlated with total sleep time in Group AHI≥ 15. Group AHI≥ 15 exhibited a negative association between FT of state 3 and Visuospatial/Executive score in MoCA (r = -0.297, p = 0.033). CONCLUSIONS Untreated male moderate to severe OSA patients exhibited altered in dFC, which significantly correlated with hypoxia parameters and cognitive performance, high lighting that dFC changes may be an indicator of the neurological consequence of OSA, especially moderate to severe OSA.

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